精神疾病篩選問卷表——設計、信度與程序效度

SCREENING SCHEDULE FOR PSYCHIATRIC DISORDERS SET-UP, RELIABILITY AND VALIDITY

本精神疾病篩選問卷是推展社區心理衛生工作的重要工具。本研究根據精神科診斷要有診斷準則之觀念，設計了本精神疾病篩選問卷表。本問卷表包含兩部份（Ⅰ）基本資料，（Ⅱ）問卷檢查。問卷檢查包括23大項問題，可以篩選25不同之精神疾病是：智能不足、痴呆、身體化症、慮病症、心身症、厭食症、一般焦慮症、驚慌症、憂鬱症、躁症、循環性情緖障碍症、畏懼症、適應困難、強迫症、精神分裂病、其他非情感性精神病（包括妄想症），精神分裂性人格違常、煙癮、酒癮、藥癮、反社會人格違常、病態賭博、性功能異常、同性症、變性症。另外，第24項問題是篩選一些較少見之其他各類精神疾病。本研究並以非醫師心理衛生人員做評分者信度與程序效度研究。發現以Kappa和Random Error Coefficient Agreement做統計分析，其評分者信度相當良好，而程序效度研究中發現除適應因難之標認率較低（57.1%）以外，其他各類疾病均在75%~100%之間，可謂良好，而所有嚴重精神病，均可以100%的標認出來。所以本篩選問卷，可以在一般社區心理衛生服務中，做進一步之探討，以驗證其臨床之效用。

The screening schedule for psychiatric disorder (SSPD) is an important tool for community mental health service. This SSPD was designed by the concept of criteria approach for psychiatric diagnosis. This SSPD is composed of two parts: (1) basic data, (2) screening schedule. The screening schedule has 23 main items to screen 25 categories of psychiatric disorders. These are: mental retardation, dementia, somatization disorder, hypochondriasis, psychophysiological disorder, anorexia nervosa, generalized anxiety disorder, panic disorder, depressive disorder, manic episode, cyclothymic disorder, phobic disorder, adjustmental disorder, obsessive disorder, schizophrenic disorder, other non-affective psychotic disorder (such as paranoid disorder), schizoid personality disorder, antisocial personality disorder, pathological gambling, sexual dysfunction, homosexuality, transexuality. One main item (24th) is the one for screening other rare paychiatric disorders. This study also used the non-physicians to test the inter-rater reliability and procedural validity. The kappa statistics and random error coefficient agreement were used for analysis. The result shows good inter-rater reliability. The procedural validity shows that other than the adjustmental disorder (57.1%), all the psychiatric disorders have the case identifical rate between 75%－100%. All the severe psychotic disorders can all be screened out. The SSPD is recommanded for use in community mental health service for further evaluations.